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Nutrition and Lupus
Good nutrition is an important part
of the overall treatment plan for your
lupus. A well-balanced diet provides the
necessary fuel for your body to carry on
its normal functions. Although there are
no specific dietary guidelines for people
with lupus, there are some nutrition
issues that you should know about. If
any of these issues become a problem
for you, talk with your doctor or nurse.
They will be able to provide you with
additional information and can refer you
to a registered dietitian if necessary.
Weight
loss over the previous year is commonly
reported by people who are newly
diagnosed with lupus. Weight loss and
poor appetite can result from the illness
itself or from some medications that may
cause stomach upset or mouth sores
(also called mouth ulcers).
Your doctor or nurse will assess your
weight loss and other related problems
and suggest changes in your diet to be
sure that you are eating right and have
no further weight loss.
Weight gain: This may be a problem if
you take corticosteroids. These drugs
often increase a person's appetite, and,
unless you are careful, unwanted weight
gain will occur.
Your doctor or nurse will assess your
diet and other related problems and can
suggest a program to help you control
your weight and lose any unwanted
pounds. The program will probably
include a low-fat diet, exercise, and
behavior modification. A registered
dietitian can help you evaluate your food
likes and dislikes and eating patterns
and can design a diet specifically for
your needs and lifestyle.
Difficulty taking medications: Several
medications can cause gastrointestinal
or "GI" disturbances, such as heartburn,
upset stomach, nausea, vomiting, or
painful mouth ulcers.
If you are having gastrointestinal
problems, tell your doctor or nurse
immediately. Because many of these
problems are related to how and when
a medication is taken, the dose or
schedule can sometimes be changed
to reduce or stop the unpleasant side
effects. In some cases, the doctor may
change the drug. Many medications
can be taken with food, which helps
reduce side effects. If you have mouth
ulcers, liquid forms of the drugs you are
taking may be available. In addition,
anesthetics for use in your mouth can
decrease the pain of mouth ulcers and
make swallowing easier.
Osteoporosis: This is a condition in
which the bones of the body become
less dense and break easily. Although
this condition often affects older,
postmenopausal women, it can also
affect anyone who takes corticosteroids
for a long period of time.
Your doctor or nurse will review your
medical history, treatment plan, diet,
and any risk factors you may have.
Measurements of your bone density
may also be taken. The most widely
recognized bone mineral density
test is called a dual-energy x-ray
absorptiometry or DXA test. It is
painless - a bit like having an x ray, but
with much less exposure to radiation.
Recommendations to prevent or reduce
the problem will probably include a diet
high in calcium (1,000-1,500 mg/day)
and vitamin D (100-500 mg/day) and
an exercise plan that is appropriate
for you. Calcium supplements may be
prescribed by your doctor if the calcium
in your diet is not enough.
Steroid-induced diabetes: Diabetes is
a condition in which your body does
not produce enough insulin to maintain
a normal blood glucose (sugar) level.
Long-term use of corticosteroids may
cause diabetes, which must be treated
in the same way as it is for other people
with diabetes.
After a thorough physical and dietary
exam, your doctor will probably place
you on a special diet. You should
consult with a registered dietitian who
can help you understand the various
aspects of the diet, and learn to plan
your meals more easily. You may also
have to take a drug to help keep your
glucose levels within normal limits. For
some people, a pill may be prescribed;
for others, insulin given by injection
may be necessary.
If you are diagnosed with steroid induced
diabetes, ask your doctor
or nurse to refer you to a diabetes
education program. These programs
help newly diagnosed people with
diabetes learn about their disease
and manage their condition so that
they continue to live a healthy and
productive life. If a program is not
available where you live, a registered
dietitian should be able to give you the
information you need.
Kidney disease: Because the kidneys are
often affected by lupus, your doctor will
probably order a variety of tests every so
often to see how well your kidneys are
working. If your doctor determines that
your lupus has affected your kidneys,
the goals for treating the problem will
be to preserve as much kidney function
as possible and prevent the condition
from getting worse. Along with other
treatment options, you may be placed
on a low-sodium (salt), low-potassium,
or low-protein diet. A registered dietitian
can help you plan meals for these diets.
Cardiovascular disease: Cardiovascular
complications of lupus include
atherosclerosis and high blood pressure.
Atherosclerosis is a condition in which
fatty deposits build up on the inside of
the arteries. These deposits can reduce
or block blood flow. High blood pressure
increases the risk of having a heart
attack or stroke. High blood pressure
can happen when lupus damages the
kidneys, which help regulate blood
pressure.
If your doctor determines that you have
risk factors for atherosclerosis, you will
probably be placed on a low-fat diet and
an exercise plan. These will help you
lower your blood cholesterol level and
maintain a good body weight. If you
have high blood pressure, you may be
placed on a low-sodium diet, medication,
or both. These will help reduce your
blood pressure to within normal limits.
Source: National Institutes of Health, U.S.Dept of Health and Human Services
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